Related Experiment Video
Updated: Jun 18, 2026
04:27
Intratracheal Instillation of Stem Cells in Term Neonatal Rats
Published on: May 4, 2020
Surfactant in the preterm infant: what's going on
Carlo Dani1, Jacopo Barp, Elettra Berti
1Department of Surgical and Medical Critical Care, Section of Neonatology, Careggi University Hospital of Florence, Florence, Italy. cdani@unifi.it
Summary
Surfactant therapy reduces lung problems and death in premature infants. Natural surfactants and early treatment are most effective, with ongoing research into improved surfactant strategies for respiratory distress syndrome.
Area of Science:
- Neonatal Medicine
- Pulmonology
- Biochemistry
Background:
- Surfactant administration is a cornerstone in managing respiratory distress syndrome (RDS) in preterm infants.
- Established benefits include reduced pneumothorax and mortality.
- Current clinical practice is evolving due to widespread antenatal steroid use and nasal continuous positive airway pressure (nCPAP).
Purpose of the Study:
- To review the current evidence on surfactant treatment strategies for preterm infants.
- To discuss the evolving role of surfactant prophylaxis versus rescue therapy.
- To explore future directions for enhancing surfactant therapy, particularly for preventing bronchopulmonary dysplasia (BPD).
Main Methods:
- Review of existing literature on surfactant therapy in neonatal respiratory distress.
- Analysis of clinical trial data comparing different surfactant types and treatment timings.
- Examination of the impact of antenatal steroids and nCPAP on RDS management.
Main Results:
- Natural surfactants demonstrate superior efficacy compared to synthetic alternatives.
- Early surfactant rescue treatment is more beneficial than delayed treatment.
- The indications for surfactant prophylaxis are being re-evaluated in light of modern RDS management.
Conclusions:
- Surfactant therapy remains critical for preterm infants with RDS, with a preference for natural surfactants and early intervention.
- The changing clinical landscape necessitates a re-evaluation of optimal surfactant strategies.
- Future research may focus on augmenting exogenous natural surfactants with anti-inflammatory and antioxidant agents to combat lung injury and prevent BPD.
Related Concept Videos
01:05Breathing
The process of breathing, inhaling and exhaling, involves the coordinated movement of the chest wall, the lungs, and the muscles that move them. Two muscle groups with important roles in breathing are the diaphragm, located directly below the lungs, and the intercostal muscles, which lie between the ribs. When the diaphragm contracts, it moves downward, increasing the volume of the thoracic cavity and creating more room for the lungs to expand. When the intercostal muscles contract, the ribs...
01:17Pulmonary Cycle: Exhalation
In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
01:19Factors Affecting Pulmonary Ventilation
Besides the pressure difference between the external environment and the lungs, the airflow rate and ease of pulmonary ventilation are also influenced by three other factors: surface tension of the fluid in the alveoli, compliance of the lungs, and airway resistance.
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
01:10Atelectasis II: Pathophysiology
Atelectasis develops when alveoli lose their air and collapse inward. Because lung tissue is naturally elastic, these air sacs shrink rather than remaining open. Collapsed alveoli are no longer ventilated, reducing their role in gas exchange. Blood flow may continue in these regions, creating a ventilation–perfusion mismatch. Clinical findings include decreased breath sounds, dullness to percussion, reduced chest expansion, and decreased tactile fremitus as sound transmission through collapsed...
01:27Surface Active Agents
Surfactants, named for their behavior at interfaces, positively adsorb at the interfaces of two phases, reducing interfacial tension. Their versatility as emulsifiers, detergents, and foaming agents stems from this ability. Surfactants, often termed amphiphiles, share the property of amphipathy, with molecules having both hydrophilic and hydrophobic portions. The hydrophilic part is called the head, and the hydrophobic part, including an elongated alkyl substituent, forms the tail.Surfactants...
01:30Micelles
Micelle formation is an intricate process that hinges on the properties of amphiphilic or amphipathic molecules and the conditions of the system in which they are found. Amphiphilic molecules, which have both hydrophilic (water-attracting) and hydrophobic (water-repelling) parts, play a critical role in this process.In aqueous environments, these molecules arrange themselves such that their hydrophilic heads are turned towards the water phase, while their hydrophobic tails are oriented away...